TY - JOUR
T1 - Clinical Outcomes of Ticagrelor in Korean Patients with Acute Myocardial Infarction without High Bleeding Risk
AU - Park, Keun Ho
AU - Jeong, Myung Ho
AU - Kim, Hyun Kuk
AU - Ki, Young Jae
AU - Kim, Sung Soo
AU - Choi, Dong Hyun
AU - Koh, Young Youp
AU - Ahn, Youngkeun
AU - Kim, Hyo Soo
AU - Gwon, Hyeon Cheol
AU - Rha, Seung Woon
AU - Hwang, Jin Yong
AU - on behalf of the KAMIR-NIH registry investigators, behalf of the KAMIR-NIH registry investigators
N1 - Funding Information:
The present study was supported by grants from the Clinical Medicine Research Institute at Chosun University Hospital, 2016 and by a fund from the Research of Korea Centers for Disease Control & Prevention (2016-ER6304-02), Korea.
Publisher Copyright:
© 2021. The Korean Academy of Medical Sciences. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https:// creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly.
PY - 2021
Y1 - 2021
N2 - Background: Although ticagrelor is known to increase the bleeding risk compared to clopidogrel in East Asian patients, its clinical benefits in patients with acute myocardial infarction (AMI) without high bleeding risk (HBR) remains unknown. Methods: A total of 7,348 patients who underwent successful percutaneous coronary intervention (PCI) from the Korea Acute Myocardial Infarction Registry-National Institute of Health (KAMIR-NIH), between November 2011 and December 2015, were divided into two groups according to the Academic Research Consortium for HBR criteria (KAMIR-HBR, 2,469 patients; KAMIR-non HBR, 4,879 patients). We compared in-hospital major adverse cardiovascular events (MACEs, defined as a composite of cardiac death, non-fatal myocardial infarction, or stroke), and the thrombolysis in myocardial infarction (TIMI) major bleeding between ticagrelor and clopidogrel in the KAMIR-HBR and the KAMIR-non HBR groups, respectively. Results: After propensity score matching, ticagrelor had a higher incidence of in-hospital TIMI major bleeding than clopidogrel in all patients (odds ratio [OR], 1.683; 95% confidence interval [CI], 1.010–2.805; P= 0.046) and the KAMIR-HBR group (OR, 3.460; 95% CI, 1.374–8.714; P= 0.008). However, there was no significant difference in in-hospital TIMI major bleeding between ticagrelor and clopidogrel in the KAMIR-non HBR group (OR, 1.436; 95% CI, 0.722–2.855; P= 0.303). No differences were observed in the cumulative incidences of in-hospital and 6-month MACEs between ticagrelor and clopidogrel in both groups. Conclusions: The bleeding risk of ticagrelor was attenuated in Korean patients with AMI without HBR. Appropriate patient selection could reduce in-hospital bleeding complications associated with ticagrelor in Korean patients with AMI who underwent successful PCI.
AB - Background: Although ticagrelor is known to increase the bleeding risk compared to clopidogrel in East Asian patients, its clinical benefits in patients with acute myocardial infarction (AMI) without high bleeding risk (HBR) remains unknown. Methods: A total of 7,348 patients who underwent successful percutaneous coronary intervention (PCI) from the Korea Acute Myocardial Infarction Registry-National Institute of Health (KAMIR-NIH), between November 2011 and December 2015, were divided into two groups according to the Academic Research Consortium for HBR criteria (KAMIR-HBR, 2,469 patients; KAMIR-non HBR, 4,879 patients). We compared in-hospital major adverse cardiovascular events (MACEs, defined as a composite of cardiac death, non-fatal myocardial infarction, or stroke), and the thrombolysis in myocardial infarction (TIMI) major bleeding between ticagrelor and clopidogrel in the KAMIR-HBR and the KAMIR-non HBR groups, respectively. Results: After propensity score matching, ticagrelor had a higher incidence of in-hospital TIMI major bleeding than clopidogrel in all patients (odds ratio [OR], 1.683; 95% confidence interval [CI], 1.010–2.805; P= 0.046) and the KAMIR-HBR group (OR, 3.460; 95% CI, 1.374–8.714; P= 0.008). However, there was no significant difference in in-hospital TIMI major bleeding between ticagrelor and clopidogrel in the KAMIR-non HBR group (OR, 1.436; 95% CI, 0.722–2.855; P= 0.303). No differences were observed in the cumulative incidences of in-hospital and 6-month MACEs between ticagrelor and clopidogrel in both groups. Conclusions: The bleeding risk of ticagrelor was attenuated in Korean patients with AMI without HBR. Appropriate patient selection could reduce in-hospital bleeding complications associated with ticagrelor in Korean patients with AMI who underwent successful PCI.
KW - Hemorrhage
KW - Myocardial Infarction
KW - P2Y12 Receptor Inhibitors
KW - Percutaneous Coronary Intervention
UR - http://www.scopus.com/inward/record.url?scp=85117402581&partnerID=8YFLogxK
U2 - 10.3346/JKMS.2021.36.E268
DO - 10.3346/JKMS.2021.36.E268
M3 - Article
C2 - 34725976
AN - SCOPUS:85117402581
VL - 36
SP - 1
EP - 16
JO - Journal of Korean Medical Science
JF - Journal of Korean Medical Science
SN - 1011-8934
IS - 42
ER -